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Individual

DR. DAVID BO LEE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
942 W ORANGETHORPE AVE, FULLERTON, CA 92832-2827
(714) 525-1130
(714) 525-1415
Mailing address
942 W ORANGETHORPE AVE, FULLERTON, CA 92832-2827
(714) 525-1130
(714) 525-1415

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46196
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
B46196-01
DELTA DENTAL HEALTHY FAMI
CA
01
G93421-01
MEDI-CAL PROVIDER #
CA
Enumeration date
07/26/2006
Last updated
07/08/2007
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